A laboratory-scale, four-stage continuous flow reactor system was constructed to test the viability of high-strength acid mine drainage (AMD) and municipal wastewater (MWW) passive co-treatment. The synthetic AMD had pH 2.60 and 1860 mg/L acidity as CaCO3 equivalent with 46, 0.25, 2, 290, 55, 1.2 and 390 mg/L of Al, As, Cd, Fe, Mn, Pb and Zn, respectively. The AMD was introduced to the system at a 1:2 ratio with raw MWW from the City of Norman, Oklahoma USA containing 265 ± 94 mg/L BOD5, 11.5 ± 5.3 mg/L PO4-3, and 20.8 ± 1.8 mg/L NH4+-N. During the 135 d experiment, PO4-3 and NH4+-N were decreased to <0.75 and 7.4 ± 1.8 mg/L, respectively. BOD5 was generally decreased to below detection limits. Nitrification increased NO3- to 4.9 ± 3.5 mg/L NO3--N, however relatively little denitrification occurred. Results suggest that the nitrogen processing community may require an extended period to mature and reach full efficiency. Overall, results indicate that passive AMD and MWW co-treatment is a viable ecological engineering approach for the developed and developing world that can be optimized and applied to improve water quality with minimal use of fossil fuels and refined materials.